Sebetsa se Secha sa Tlhahlobo ea Lefuba le Tlhahlobo ea ho hanyetsa Lithethefatsi: Moloko o Mocha oa Targeted Sequencing (tNGS) e Kopantsoeng le ho Ithuta ka Mochini bakeng sa Tlhahlobo ea lefuba ea Hypersensitivity.
Tlaleho ea lingoliloeng: CCa: mohlala oa tlhahlobo o thehiloeng ho tNGS le ho ithuta ka mochine, o loketseng batho ba nang le lefuba le fokolang la baktheria le meningitis ea lefuba.
Sehlooho sa Thesis: Tatelano ea moloko o latelang e lebisitsoeng ho lefuba le ho ithuta ka mochini: leano la tlhahlobo e matla haholo bakeng sa li-tubular tsa paucific pulmonary le tubular meningitis.
Nako le nako: 《Clinica Chimica Acta》
HAEBA: 6.5
Letsatsi la phatlalatso: Pherekhong 2024
E kopantsoe le Univesithi ea Chinese Academy of Sciences le Sepetlele sa Beijing Chest ea Capital Medical University, Macro & Micro-Test e thehile mohlala oa tlhahlobo ea lefuba e thehiloeng molokong o mocha oa thekenoloji ea tatellano (tNGS) le mokhoa oa ho ithuta mochine, o faneng ka kutloisiso e phahameng ea ho lemoha lefuba le libaktheria tse fokolang le meningitis ea lefuba, e fane ka mokhoa o mocha oa ho hlahloba lefuba, ho fana ka mokhoa o mocha oa ho hlahloba lefuba le mefuta e 'meli ea lefuba. ho lemoha le ho alafa lefuba. Ka nako e ts'oanang, ho fumanoa hore plasma cfDNA ea mokuli e ka sebelisoa e le mofuta o loketseng oa sampole bakeng sa sampole ea bongaka ha ho hlahlojoa TBM.
Thutong ena, lisampole tse 227 tsa plasma le lisampole tsa mokelikeli oa cerebrospinal li ile tsa sebelisoa ho theha lihlopha tse peli tsa bongaka, moo lisampole tsa tlhahlobo ea tlhahlobo ea laboratori li sebelisitsoeng ho theha mofuta oa ho ithuta ka mochini oa tlhahlobo ea lefuba, 'me lisampole tsa tlhahlobo ea kliniki li ile tsa sebelisoa ho netefatsa mohlala oa tlhahlobo o thehiloeng. Mehlala eohle e ile ea tobisoa pele ke letamo le reretsoeng ho tšoara lefuba la Mycobacterium. Joale, ho ipapisitsoe le data ea tatellano ea TB-tNGS, mohlala oa sefate sa qeto o sebelisoa ho etsa netefatso ea makhetlo a 5 ho lithupelo le lithupelo tsa letoto la tlhahlobo ea laboratori, 'me ho fumanoa litekanyo tsa tlhahlobo ea lisampole tsa plasma le lisampole tsa cerebrospinal fluid. Monyako o fumanoeng o kenngoa ka lihlopha tse peli tsa liteko tsa tlhahlobo ea kliniki bakeng sa ho fumanoa, 'me ts'ebetso ea tlhahlobo ea moithuti e hlahlojoa ke ROC curve. Qetellong, mokhoa oa ho hlahloba lefuba o ile oa fumanoa.
Setšoantšo sa 1 sa moralo oa moralo oa lipatlisiso
Liphello: Ho ea ka menyako e ikhethileng ea sampole ea CSF DNA (AUC = 0.974) le sampole ea cfDNA ea plasma (AUC = 0.908) e khethiloeng thutong ena, har'a lisampole tse 227, kutlo ea sampole ea CSF e ne e le 97.01%, e ikhethang e ne e le 95.65%, 'me plasma ea 8 le sampole e ikhethang e ne e le 8.61%. 86.36%. Mo tshekatshekong ya disampole tse 44 tse pakilweng tsa plasma cfDNA le cerebrospinal fluid DNA ho tsoa ho bakuli ba TBM, leano la tlhahlobo ea phuputso ena le na le tumellano e phahameng ea 90.91% (40/44) ho plasma cfDNA le cerebrospinal fluid DNA, mme kutlo ke 95.45% (42/42). Ho bana ba nang le lefuba la matšoafo, leano la tlhahlobo ea phuputso ena le nahanela lisampole tsa plasma ho feta liphetho tsa Xpert tsa lisampole tsa lero la gastric ho tsoa ho bakuli ba tšoanang (28.57% VS 15.38%).
Setšoantšo sa 2 Ts'ebetso ea tlhahlobo ea mohlala oa tlhahlobo ea lefuba bakeng sa mehlala ea baahi
Setšoantšo sa 3 Liphetho tsa tlhahlobo ea mehlala e kopantsoeng
Qetello: Mokhoa oa ho hlahloba lefuba oa hypersensitive bakeng sa lefuba o thehiloe thutong ena, e ka fanang ka sesebelisoa sa ho hlahloba se nang le kutloisiso e phahameng ka ho fetisisa ea ho lemoha ho bakuli ba kliniki ba nang le oligobacillary tuberculosis (setso se mpe). Ho sibolloa ha lefuba le hypersensitive ho latela plasma cfDNA e kanna ea ba mohlala o nepahetseng oa tlhahlobo ea lefuba le lefuba la meningitis (ho bonolo ho bokella lisampole tsa plasma ho feta mokelikeli oa cerebrospinal bakeng sa bakuli ba belaelloang ba lefuba la boko).
Sehokelo sa mantlha: https://www.sciencedirect.com/science/article/pii/s0009898123004990? ka%3Dihub
Kenyelletso e khutšoane ea lihlahisoa tsa ho lemoha lefuba la Macro & Micro-Test
Ka lebaka la boemo bo rarahaneng ba sampole ea bakuli ba lefuba le litlhoko tse fapaneng, Macro & Micro-Test e fana ka sete e felletseng ea litharollo tsa NGS bakeng sa ho ntšoa ha liquefaction ho lisampole tsa likhohlela, kaho ea laebrari ea Qualcomm le tatellano, le tlhahlobo ea data. Lihlahisoa li koahela tlhahlobo e potlakileng ea bakuli ba lefuba, ho lemoha ho hanyetsa lithethefatsi tsa lefuba, ho thaepa lefuba la mycobacterium le NTM, tlhahlobo ea hypersensitivity ea lefuba le baktheria le batho ba lefuba, joalo-joalo.
Lisebelisoa tsa ho lemoha lefuba le mycobacteria:
| Ntho No | lebitso la sehlahisoa | lihlahisoa tsa tlhahlobo ea lihlahisoa | mofuta oa mohlala | mohlala o sebetsang |
| HWTS-3012 | Mohlala oa ho lokolla | E sebelisitsoe ho phekola lisampole tsa sekhohlela, e fumane nomoro ea rekoto ea boemo ba pele, Sutong Machinery Equipment 20230047. | sekhohlela | |
| HWTS-NGS-P00021 | Qualcomm quantity discovery kit bakeng sa hypersensitive tuberculosis (mokhoa oa ho ts'oara probe) | E sa hlaseleng (liquid biopsy) ho lemoha hypersensitivity bakeng sa baktheria-negative pulmonary lefuba le maqhutsu a boko; Mehlala ea batho bao ho belaelloang hore ba tšoaelitsoe ke lefuba kapa bao e seng lefuba mycobacteria e ile ea hlahlobjoa ka tatellano e tebileng ea metagenomics, le tlhahisoleseding ea ho lemoha hore na lefuba kapa mycobacteria e se nang lefuba e tšoaelitsoe 'me ho fanoe ka boitsebiso bo ka sehloohong ba ho hanyetsa lithethefatsi tsa lefuba la mycobacterium. | Mali a peripheral, alveolar lavage fluid, hydrothorax le ascites, sampuli ea ho phunya, cerebrospinal fluid. | Moloko oa bobeli |
| HWTS-NGS-T001 | Mycobacterium typing le kit ea ho lemoha ho hana lithethefatsi (multiplex amplification sequencing method) | Teko ea ho thaepa ea Mycobacterium, ho kenyeletsoa MTBC le 187 NTM;Ho lemoha ha lefuba la Mycobacterium ho hanyetsa lithethefatsi ho akaretsa litlhare tse 13 le libaka tse 16 tsa phetoho ea liphatsa tsa lefutso tse hanyetsanang le lithethefatsi. | Sekhohlela, mokelikeli oa alveolar lavage, hydrothorax le ascites, sampole ea ho phunya, mokelikeli oa cerebrospinal. | Moloko oa bobeli / oa boraro sethaleng sa bobeli |
Lintlha-khōlō: HWTS-NGS-T001 Mycobacterium ho thaepa le lisebelisoa tsa ho lemoha ho hanyetsa lithethefatsi (mokhoa oa amplification oa multiplex)
Kenyelletso ea sehlahisoa
Sehlahisoa se ipapisitse le litlhare tsa mantlha tsa moleng oa pele le oa bobeli tse hlalositsoeng ho tataiso ea kalafo ea lefuba la WHO, li-macrolides le aminoglycosides tse sebelisoang hangata litataisong tsa kalafo tsa NTM, 'me libaka tsa ho hanyetsa lithethefatsi li koahela sehlopha se le seng sa libaka tse amanang le khanyetso ea lithethefatsi lethathamong la WHO Mycobacterium tuberculosis complex mutation, hammoho le tse ling tse tlalehiloeng ka liphatsa tsa lefutso tsa ho hanyetsa lithethefatsi le libaka tsa ho feto-fetoha ha maemo ho latela lingoliloeng tsa lehae.
Boitsebiso ba ho thaepa bo ipapisitse le mefuta ea NTM e akarelitsoeng ho litataiso tsa NTM tse phatlalalitsoeng ke Chinese Journal of Tuberculosis and Respiratory Diseases le tumellano ea litsebi. Lisebelisoa tse etselitsoeng ho thaepa li ka holisa, tsa tatellana le ho hlakisa mefuta e fetang 190 ea NTM.
Ka theknoloji ea amplification e lebisitsoeng ho multiplex PCR, liphatsa tsa lefutso tsa genotyping le liphatsa tsa lefutso tse hanyetsanang le lithethefatsi tsa Mycobacterium li ile tsa matlafatsoa ke multiplex PCR, 'me motsoako oa amplicon oa liphatsa tsa lefutso tse lokelang ho fumanoa o ile oa fumanoa. Lihlahisoa tse atolositsoeng li ka hahuoa lilaebraring tsa tatellano ea lihlahisoa tse phahameng tsa moloko oa bobeli kapa oa boraro, 'me liforomo tsohle tsa moloko oa bobeli le oa boraro li ka kenngoa ka tatellano e tebileng ho fumana boitsebiso ba tatellano ea liphatsa tsa lefutso. Ka ho bapisa le liphetoho tse tsebahalang tse fumanehang polokelong ea polokelo ea litšupiso e hahelletsoeng (ho kenyeletsoa lethathamo la phetoho e rarahaneng ea lefuba la WHO Mycobacterium lefuba le kamano ea eona le khanyetso ea lithethefatsi), liphetoho tse amanang le ho hanyetsa lithethefatsi kapa ho ba le ts'oaetso ea litlhare tse thibelang lefuba li ile tsa khethoa. Ha ho kopantsoe le tharollo ea kalafo ea sekhohlela e ipuletseng ea Macro & Micro-Test, bothata ba ho sebetsa hantle ha sekhohlela ho tlase ho nucleic acid ea lisampole tsa sekhohlela (ho feta ka makhetlo a leshome ho feta mekhoa ea setso) ho ile ha rarolloa, e le hore tlhahlobo ea tatellano ea ho hanyetsa lithethefatsi e ka sebelisoa ka kotloloho ho lisampole tsa sekhohlela.
Lethathamo la ho lemoha sehlahisoa
34Liphatsa tsa lefutso tse amanang le ho hanyetsa lithethefatsi tsa18lithethefatsi tse thibelang lefuba le6Lithethefatsi tsa NTM li ile tsa fumanoa, li koahela297libaka tsa ho hanyetsa lithethefatsi; Mefuta e leshome ea lefuba la Mycobacterium le ho feta190mefuta ea NTM e ile ea fumanoa.
Letlapa la 1: Boitsebiso ba 18 + 6 Lithethefatsi +190 + NTM
Molemo oa lihlahisoa
Matla a ho ikamahanya le maemo a kliniki: lisampole tsa sekhohlela li ka bonoa ka kotloloho ka mokhoa oa ho intša metsi ntle le moetlo.
Ts'ebetso ea liteko e bonolo: mohato oa pele oa ts'ebetso ea amplification o bonolo, 'me kaho ea laebrari e phetheloa ka lihora tse 3, e leng ho ntlafatsang katleho ea mosebetsi.
Ho thaepa ka botlalo le ho hanyetsa lithethefatsi: ho koahela libaka tsa ho thaepa le ho hanyetsa lithethefatsi tsa MTB le NTM, e leng lintlha tsa bohlokoa tsa tlhokomelo ea bophelo bo botle, ho ngola ka nepo le ho lemoha ho hanyetsa lithethefatsi, ho tšehetsa software e ikemetseng ea tlhahlobo, le ho hlahisa litlaleho tsa tlhahlobo ka ho tobetsa hanngoe feela.
Ho lumellana: ho lumellana ha lihlahisoa, ho ikamahanya le maemo a tloaelehileng a ILM le MGI/ONT platforms.
Tlhaloso ea lihlahisoa
| Khoutu ea sehlahisoa | lebitso la sehlahisoa | Sethala sa ho lemoha | litlhaloso |
| HWTS-NGS-T001 | Mycobacterium ho thaepa le lisebelisoa tsa ho lemoha ho hana lithethefatsi (mokhoa oa ho holisa multiplex) | ONT, Illumina, MGI, Salus pro | 16/96rxn |
Nako ea poso: Jan-23-2024